Peroneal intraneural ganglion cysts at the fibular neck: the layered "U" surgical approach to the articular branch and superior tibiofibular joint.

Background: Intraneural ganglia most commonly occur within the peroneal nerve near the fibular neck. Disconnection of the articular branch is required in their treatment. Surgical intervention can be challenging because of unfamiliarity with the region or scarring from previous surgery.

Method: We present the layered "U" technique for peroneal intraneural ganglia with clinical examples. Dissection is carried down in parallel to the U-shaped course of the articular branch to provide optimal visualization and avoid injury to major branches of the nerve.

Conclusion: This pathoanatomic approach provides direct and safe exposure of the articular branch of the common peroneal nerve.